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Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England

A national survey

Dados Bibliográficos

ID23375184
AutoresMark A Bellis (0000-0001-6980-1963, Public Health Wales, autor correspondente), Karen Hughes (0000-0002-3631-6870, Liverpool John Moores University), Nicola Leckenby (Liverpool John Moores University), Katie Hardcastle (0000-0003-3429-5030, Liverpool John Moores University), K A Hardcastle, Claire Perkins (0000-0002-6679-4603, Public Health England), Helen Lowey (Blackburn College)
Ano2015
Volume37
Fascículo3
Páginas445-454
Data de publicação2015-09-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Public Health (JOURNAL)
Identificadores do periódicoISSN: 0943-1853 • E-ISSN: 1613-2238
EditoraOxford University Press (OUP) (PUBLISHER)
DOI10.1093/pubmed/fdu065
PMID25174044
OpenAlexW2157407278
IdiomaEN
Citações recebidas79
Referências citadas33

BACKGROUND: ACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England. METHODS: A nationally representative survey was undertaken (n = 3885, aged 18-69, April-July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality. RESULTS: Of the total, 46.4% of respondents reported ≥1 and 8.3% ≥4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus ≥4 ACEs; cancer, 2.38 (1.48-3.83); diabetes, 2.99 (1.90-4.72); stroke, 5.79 (2.43-13.80, all P < 0.001). Individuals with ≥4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (≥4 versus 0 ACEs; HR, 1.97 (1.39-2.79), P < 0.001). CONCLUSIONS: Radically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable.

Confidence interval · Environmental health · Hazard ratio · Injury prevention · Poison control · Psychiatry · Psychological intervention · Sibling · Stressor · Child Abuse and Related Trauma · Child Abuse and Trauma · Demography · Internal Medicine · Medicine · Posttraumatic Stress Disorder Research · Psychology · Gerontology

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Obras citantes distintas79
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Intervalo de citações2015 - 2026 (12)
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